Intralesional photocoagulation of vascular anomalies of the tongue

Vascular anomalies remain a challenge for patients and reconstructive surge ons. Recently, promising results have been reported using intralesional pho tocoagulation (ILP) to treat large, deep vascular lesions. We report our ex perience in treating 12 patients with vascular anomalies of the tongue (10 venous malformations and two haemangiomas) using intralesional photocoagula tion. All patients were treated with a Nd:YAG (neodymium:yttrium-aluminium- garnet) (1064 nm) laser (Sharplan, Inc., NJ, USA) delivered with a 600 mu m optical fibre. Laser power was set at 7 or 10 W, delivered with a pulse du ration of 10 s. Laser energy was delivered to all areas of the vascular les ion. Heat, visible shrinkage and firmness of the lesion signalled the end-p oint of treatment. The mean follow-up period was 9.5 months (range 3-20 mon ths). All patients demonstrated improvement as judged by a clinical assessm ent of the reduction in lesion size (mean reduction = 87%, range 60-100%). Three patients (25%) had complications attributed to photocoagulation. Ener gy delivered too superficially resulted in ulceration or scarring. These co mplications should be avoidable if this potential for harm is kept in mind.